Regenerative endodontic treatment in permanent immature teeth: Case series

Regenerative endodontic treatment is a biologically based procedure primarily indicated for the management of necrotic immature permanent teeth. Beyond achieving the resolution of periapical radiolucencies and the elimination of clinical symptoms, RET aims to promote continued root development, including the thickening of dentinal walls and apical closure, and ideally, the re-establishment of pulp vitality. This case report presents two clinical cases treated with regenerative endodontic protocols, with follow-up periods of 30 months and 12 months, respectively. The first case involves a maxillary lateral incisor that underwent a repeated regenerative procedure, while the second case pertains to a maxillary central incisor with a history of dental trauma and prior conventional root canal treatment. The irrigation protocol consisted of 1.5% sodium hypochlorite, followed by distilled water and 17% ethylenediaminetetraacetic acid. Calcium hydroxide was employed as the intracanal medicament. Biodentine (Septodont, France) was used as a coronal barrier, and definitive restorations were completed with composite resin. During the follow-up period, a secondary regenerative procedure was performed for Case 1 at the 18-month recall. At the 30-month follow-up for Case 1 and the 12-month follow-up for Case 2, both cases exhibited radiographic evidence of periapical healing and remained asymptomatic. However, both teeth yielded negative responses to pulp vitality testing and cold stimuli. Regenerative endodontic treatment is considered a promising alternative to apexification therapy for immature and necrotic teeth.

Keywords: Platelet-rich fibrine, regeneration, revascularization.